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Objective To compare the clinicopathological characteristics between primary and contralateral cancers in patients with metachronous bilateral breast cancer (MBBC) who carried a BRCA1/2 germline pathogenic variant. Methods A total of 496 BRCA1/2 carriers with primary unilateral breast cancer were included (196 with BRCA1 and 300 with BRCA2). Clinicopathological information of patients was collected, and the median follow-up for the entire cohort was 10.4 years (0.4-20.8 years). Results Among all patients, 31 (15.8%) of the 196 BRCA1 carriers and 49 (16.3%) of the 300 BRCA2 carriers had MBBC, respectively. Among the 31 BRCA1 carriers who developed MBBC, the proportion of triple-negative breast cancer (TNBC) in primary cancer and contralateral cancer was 61.3% and 67.7%, respectively. If the primary cancer of BRCA1-mutated MBBC was TNBC, the probability of the contralateral breast cancer with TNBC was 89.5% (17/19), which was significantly higher than that if the primary cancer was non-TNBC (33.3%, 4/12) (P=0.004). Among the 49 BRCA2 carriers who developed MBBC, the predominant molecular phenotype of the primary and contralateral cancers was HR+ & HER2- (77.6% and 67.3%, respectively; P=0.53). Conclusion Approximately 60% of BRCA1 carriers exhibit TNBC. If a BRCA1 carrier with a TNBC primary breast cancer had an MBBC, the probability of the contralateral breast cancer being TNBC phenotype is almost 89.5%.
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Objective:To explore the differences in therapeutic effect and prognosis of different molecular subtypes of breast invasive lobular carcinoma treated with nab-paclitaxel, so as to provide a basis for the selection of clinical drugs for breast cancer.Methods:The data of 180 patients with advanced invasive lobular carcinoma of the breast who were treated in Handan Central Hospital and the Fourth Hospital of Hebei Medical University from January 2017 to January 2020 were retrospectively analyzed, including 34 cases of Luminal A type, 92 cases of Luminal B type, 21 cases of human epidermal growth factor receptor 2 (HER2) overexpression type, and 33 cases of triple-negative type. The patients were treated with nab-paclitaxel, and the clinical curative effect was evaluated according to the solid tumor response evaluation criteria version 1.1 after 1 year of treatment, and the objective response rate (ORR) (calculated as complete remission + partial remission) and clinical benefit rate (CBR) (calculated as complete remission + partial remission + stable disease) were calculated; the occurrence of adverse reactions during the treatment was recorded. The Kaplan-Meier method was used to draw the progression-free survival (PFS) and overall survival (OS) curves for each subtype of patients, and the log-rank method was used to test them.Results:The differences in ORR and CBR among patients with the four subtypes of Luminal A, Luminal B, HER2 overexpression, and triple-negative were statistically significant (all P < 0.001), with the triple-negative type having the lowest ORR and CBR [21.2% (7/33) and 63.6% (21/33)] and the Luminal A type having the highest ORR and CBR [70.6% (24/34) and 100.0% (34/34)]. The ORR and CBR of Luminal B type were 45.7% (42/92) and 90.2% (83/92), and the HER2 overexpression type was 38.1% (8/21) and 90.5% (19/21). The differences in the incidence of myelosuppression, numbness of limbs, joint and muscle pain among the four subtypes were statistically significant (all P < 0.05), with the triple-negative type having the highest incidence of all of the above adverse reactions. The PFS and OS of triple-negative subtype were worse than those of Luminal A, Luminal B and HER2 overexpression subtypes, and the differences were statistically significant (all P < 0.05). Conclusions:The clinical response and prognosis of patients with different molecular subtypes of invasive lobular carcinoma is significantly different after nab-paclitaxel intervention, among which the prognosis of patients with triple-negative type is the worst, and the clinical medication can be guided according to the pathological test results.
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Small cell lung cancer (SCLC) is a malignant tumor with remarkable proliferative and invasive ability, which has very poor clinical prognosis due to lack of effective treatments. In recent years, researches on cells, animal models and tumor samples have promoted the identification of molecular subtypes of SCLC, discovered unique biological and clinical characteristics, and proposed potential specific therapeutic targets for different subtypes. This will encourage the development of more accurate therapeutic strategies towards SCLC, with a view to improving the prognosis of the patients. This article will review the current SCLC molecular subtypes, focus on the clinical characteristics and therapeutic strategies of different SCLC subtypes, and propose reasonable suggestions for the future treatment of SCLC. .
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Animals , Small Cell Lung Carcinoma/therapy , Lung Neoplasms/therapy , Immunotherapy , PrognosisABSTRACT
Acute respiratory distress syndrome(ARDS)is one of the most common complications of sepsis, resulting in the high risk of death in patients with sepsis.By comparison with non-septic ARDS, sepsis-associated ARDS is characterized by high morbidity, heterogeneity and mortality.It is vital to early identify the occurrence of ARDS, accurately assess the severity, as well as effectively implement the individualized treatment.Based on the genome-wide association study, mass cytometry, and multiple omics data analysis, the molecular signatures of sepsis-associated ARDS have been elucidated, which were related to genetic susceptibility, inflammatory reaction pathway, and metabolic characteristics.The development of novel biomarkers is helpful to molecular classifier, risk stratification, early recognition and assessing severity, implement early intervention, then improving the prognosis.
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Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.
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OBJECTIVES@#Clarifying the expression of breast cancer receptor is the key to clinical treatment for breast cancer. This study aims to explore the correlation between X-ray and clinical characteristics of 4 molecular subtypes and their receptor types of breast cancer.@*METHODS@#A total of 439 breast cancer patients who confirmed by pathology and performed X-ray examination were enrolled. The X-ray and clinical characteristics of 4 molecular subtypes and the expression of their receptors were analyzed.@*RESULTS@#Luminal A type showed the highest proportion of spiculate masses, and the lowest calcification score, showing significant difference with other 3 subtypes (all @*CONCLUSIONS@#Four molecular subtypes of breast cancer and their receptor expressions are correlated with X-ray and clinical characteristics, which can provide a basis for clinical diagnosis and treatment.
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Female , Humans , Biomarkers, Tumor , Breast Neoplasms/genetics , Receptor, ErbB-2/genetics , Receptors, Estrogen , Receptors, Progesterone , X-RaysABSTRACT
Objective:To explore the predictive value of various specific sonographic features on molecular subtypes for invasive breast carcinoma(IBC).Methods:Sonographic and clinicopathological data were retrospectively reviewed for 500 IBC patients who accepted surgical therapy in Fudan University Shanghai Cancer Center from January 2014 to March 2016. All tumors were divided into 5 molecular subtypes. The relationships of sonographic variations associated with the molecular subtypes for IBC were analyzed by univariate and multivariate Logsitic regression analyses.Results:Specific sonographic features for triple-negative subtype included regular shape ( OR=2.06, P=0.018), no spiculated/angular margin ( OR=1.98, P=0.029), posterior acoustic enhancement ( OR=2.26, P=0.005), and no calcification ( OR=2.13, P=0.006). Specific sonographic feature for human epidermal growth factor receptor-2 positive (HER2) subtype was posterior acoustic enhancement ( OR=2.23, P=0.006). Specific sonographic features for Luminal A subtype included spiculated/angular margin ( OR=2.24, P=0.001), posterior acoustic shadow ( OR=1.84, P=0.026), and no calcification ( OR=1.89, P=0.016). There were no specific sonographic features for the Luminal B with HER2 negative subtype, while that for the Luminal B with HER2 positive subtype was calcification ( OR=3.61, P<0.001). However, when used these sonographic features to predict molecular subtypes of breast cancer, the sensitivity values were 8.4%-57.3%, and positive predictive values were 9.5%-53.3%. Conclusions:The variety of sonographic features is associated with molecular subtypes of IBC.However, due to the overlap of sonographic features between different subtypes, molecular subtypes of IBC cannot be predicted by sonographic features.
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Background: Breast cancer is a leading cause of cancer death in women worldwide. Breast carcinoma is currently managed by assessing clinicopathological features. Elucidation of molecular mechanisms of pathogenesis of breast carcinoma may lead to the development of new targeted therapies, particularly in triple negative cancers. Literature shows a few studies on the expression of calretinin in breast carcinoma particularly in basal like type and its prognostic significance. In this study, authors are trying to assess the expression of a new marker calretinin in different molecular subtypes of invasive carcinoma breast.Methods: This study was done in 107 cases of invasive carcinoma breast specimens received in Department of Pathology, Government Medical college, Kottayam from December 2017 to May 2019.Results: Among the molecular subtypes, Basal like tumours showed 68.4% of cases with high level and 31.6% of cases with low level calretinin expression which is comparable with the study by Farrag et al. All the other molecular subgroups showed predominantly low level of calretinin expression.Conclusions: Different molecular subtypes of invasive carcinoma breast showed varied calretinin expression. High level calretinin expression was significantly associated with grade 3 (p value = 0.002), ER negativity (p = 0.004), PR negativity (p = 0.018) and Basal like molecular subtype (p : <0.001). This suggests that calretinin might play a role in pathogenesis of basal like breast carcinomas.
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El cáncer de mama es una de las patologías más frecuentes a nivel mundial y en el Ecuador ocupa un sitio importante dentro de la mortalidad; en pacientes con tumores de estadios avanzados la quimioterapia neodyuvante es el procedimiento indicado para lograr una reducción tumoral satisfactoria. El objetivo fue determinar la respuesta clínica y patológica en pacientes con cáncer de mama tratadas con quimioterapia neoadyuvante según cada subtipo molecular, atendidos en el hospital "Teodoro Maldonado Carbo" en el período 2015 a 2017. Se hizo uso de un diseño no experimental, transversal de tipo correlacional. Pacientes con cáncer de mama que recibieron neoadyuvancia, en su mayoría con quimioterapia basada en antraciclinas y taxanos. Se clasificó a las pacientes por sus subtipos moleculares, los mismos se obtuvieron en base a las características inmunohistoquímicas de los reportes de patología que constan en el sistema AS-400. Se comprobó la respuesta clínica al tratamiento usando los Criterios RECIST 1.1. Como resultado los 171 pacientes fueron analizados. La edad promedio de las pacientes fue 55 13 años de edad; el 25% fueron luminal B (HER+), 24% luminal B (HER-), 22% triple negativo, 18% HER2+ y 12% luminal A; el 52% de las pacientes tuvieron estadio III de la enfermedad; el 75% (129) de las pacientes fue realizada una mastectomía radical modificada. Se pudo concluir que la respuesta patológica completa en pacientes con tratamiento neoadyuvante se relaciona con los subtipos moleculares y esto es estadísticamente significativo. Además, se evidenció las mayores tasas de respuesta patológica completa en los grupos moleculares de HER2+ y triple negativo.
Breast cancer is one of the most frequent pathologies worldwide and in Ecuador it occupies an important place in mortality. In patients with advanced stage tumors, the neo-adjuvant chemotherapy is the indicated procedure to achieve a satisfactory tumor reduction. The aim was to determine the clinical and pathological response in patients with breast cancer treated with neoadjuvant chemotherapy according to each molecular subtype, treated at the "Teodoro Maldonado Carbo" hospital in the period 2015 to 2017. We used a non-experimental, crosssectional type design. Patients with breast cancer who received neoadjuvant, mostly with chemotherapy based on anthracyclines and taxanes. The patients were classified by their molecular subtypes, they were obtained based on the immunohistochemical characteristics of the pathology reports that appear in the AS-400 system. The clinical response to treatment was checked using the RECIST 1.1 Criteria. As a result, a sum of 171 patients were analyzed. The average age of the patients was 55 + 13 years old; 25% were luminal B (Her +), 24% luminal B (Her-), 22% triple negative, 18% Her2 + and 12% luminal A; 52% of the patients had stage III of the disease; 75% (129) of the patients underwent a modified radical mastectomy. As a conclusion, the complete pathological response in patients with neoadjuvant treatment is related to molecular subtypes and this is statistically significant. Also, the highest rates of complete pathological response in the molecular groups of Her2 + and triple negative were evident.
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Humans , Female , Middle Aged , Breast Neoplasms/drug therapy , Chemotherapy, Adjuvant , Anthracyclines/therapeutic use , Taxoids/therapeutic use , Breast Neoplasms/classification , Breast Neoplasms/pathology , Cross-Sectional Studies , Dose-Response Relationship, Drug , Drug Therapy, CombinationABSTRACT
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a pathological subtype of lung neuroendocrine cancer, which accounts for 2.4%-3.1% in surgical specimens of lung cancer. It is characterized by high invasiveness and poor prognosis, and highly correlated with smoking. There are few relevant studies due to the low incidence and small sample size. Therefore, it is relatively difficult to diagnosis and treatment in clinical practice. In this review, we described molecular subtype, diagnostic and prognostic-related markers about large cell neuroendocrine carcinoma of lung based on the recent progress in genomic sequencing and molecular markers, to find the direction for the next research. .
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Objective: To observe elastic features of breast cancer with different molecular subtype using virtual touch tissue imaging quantification (VTIQ) technique. Methods: Totally 101 patients with pathologically proven breast cancers were collected. All patients underwent preoperative routine ultrasound and VTIQ examination. The elastic features and the maximum shear wave velocity (SWVmax) were obtained with VTIQ technique, and the molecular subtypes of breast cancers were recorded according to pathological findings after surgical resection. The elastic features and SWVmax of different molecular subtype breast cancer were analyzed. Results: The predominant elastic model of Luminal tumor was edge advantage, of human epidermal growth factor receptor-2epidermal growth factor 2 (HER-2) expression type tumor was center advantage, while of triple-negative type tumor was homogeneity (PLuminal B type>HER-2 expression type>triple-negative type. No significant difference of SWVmax in central region of breast cancer was observed among different molecular subtypes (P>0.05), nor of SWVmax in tumor surrounding tissue (P>0.05). Conclusion: The elastic features and SWVmax, especially in the marginal regions of breast cancers are related with molecular subtype,which may reflect the biological characteristics of breast cancer on certain degree. VTIQ may be helpful to treatment planning and evaluation on prognosis of breast cancer.
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Objective: To detect the expressions of proto-oncogene protein FOSB and cyclin protein P16 in the different molecular subtypes of breast invasive ductal cancer and their correlation. Methods: The tumor tissues of 138 patients diagnosed with breast invasive ductal cancer by postoperative pathological examinations in Zhongshan Bo'ai Hospital from August 2013 to March 2019 were collected with normal breast tissues as control. Immunohistochemical staining was performed for the expressions of FOSB and P16 to investigate their correlation in the breast cancer. Besides, their expressions and their correlations in the different molecular subtypes of breast cancers, i.e. Luminal A, Luminal B [According to the expression of human epidermal growth factor 2 (HER2), it can be divided into HER2- and HER2+.], HER2 positive subtype, and triple-negative breast cancer (TNBC), were also detected. Results: ① The expression level of FOSB in 138 cases of breast invasive ductal cancer tissues was negatively correlated with P16 (r= -0.181, P=0.033). ② The expression of FOSB was significantly higher in Luminal A than those in other subtypes (P=0.028, P=0.033, P=0.001, P=0.010), while the expression of P16 was significantly higher in TBNC than those in other subtypes (P=0.025, P=0.005, P=0.008, P=0.011). ③ The expression level of FOSB in TBNC was negatively correlated with the expression of P16 (r=-0.566, P=0.018). Conclusion: The expressions of FOSB and P16 in the different molecular subtypes of breast invasive ductal cancer are different. The expression level of FOSB significantly increases in Luminal A, and that of P16 significantly increases in TBNC. There is a negative correlation between the expression levels of FOSB and P16 in TBNC.
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Background: Breast cancers have been subclassified on the basis of molecular expression. This study evaluates the receptor expression in breast carcinoma by immunohistochemistry and classifies them into various subtypes. A comparison with other regions was also made. Methods: This prospective study included all the patients of breast carcinoma who had undergone the surgical treatment of mastectomy at SMSMC from January 2014 to June 2017. Immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) was studied and subtypes were determined. Comparison of the receptor expression and patterns was done in different age groups and with other regions. Results: ‘A total of 496 cases were included in this study. The mean age at diagnosis was 48.2 years. Most of the patients (60.3%) were less than 50 years old whereas 39.7% were above 50 years. By Bloom Richardson scoring 28.7%, 56.8% and 14.5% tumours were classified as Grade I, Grade II and Grade III respectively. ER, PR and HER2neu receptor positivity was seen in 57.5%, 44.1% and 26.6% respectively. The most common molecular subtype was luminal A (41.7%) followed by triple negative subtype (30.8%). Luminal B and HER2neu overexpressing types were 15% and 12.5% respectively. Conclusion: Immunohistochemical markers act as surrogate markers for molecular classification of breast cancers. Hormone receptor expression at our institute was comparable with other studies from India. Luminal A is the most common occurring subtype of breast cancer presenting at our institute.
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Objective To investigate the feasibility and clinical significance of sentinel lymph node biopsy(SLNB) after neoadjuvant chemotherapy (NAC) for axillary lymph node-positive breast cancer.Methods Enrolled for a prospective cohort study were 167 patients from Jan 2016 to Jan 2018 with axillary lymph node-positive breast cancer admitted to the Cancer Hospital of Chinese Academy of Medical Sciences.SLNB was performed after NAC by lymphatic dual mapping,followed by axillary lymph node dissection.The primary end point was sentinel lymph node identification rate (IR) and false negative rate (FNR).Results 62 patients (37.1％) had complete pathological response of axillary lymph nodes.There was a significant difference of NAC response in patients with different subtypes (P ＜0.001).The IR of SLNB after NAC was 94.6％,the FNR was 6.7％,the sensitivity was 93.3％,the specificity was 100％,and the accuracy was 95.8％.Univariate analysis showed that there was no significant difference between tumor stage,hormone receptor status,HER2 expression,and pathological remission in SLN detection group and the SLN undetected group (P ＞ 0.05).The proportion of patients who received breast conserving surgery in the undetected group was significantly higher than that in the test group (P =0.006).Conclusions Sentinel lymph node biopsy after breast neoadjuvant chemotherapy by lymphatic dual mapping is highly accurate with a high identification rate and a low false negative rate.
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Objective@#To investigate the expression differences of serum tumor markers, such as CEA, CA125 and CA15-3, in different molecular subtypes of breast cancer and their correlations with recurrence and metastasis. @*Methods@#The medical records and follow-up data from 212 patients with breast cancer were retrospectively analyzed. According to the expression of hormone receptor, breast cancer were divided into four molecular subtypes: Luminal A, Luminal B, Her-2 overexpression and Basal-like. The clinical characteristics and levels of CEA, CA125 and CA15-3 in different molecular subtypes of breast cancer patients before operation were compared, and the factors influencing the recurrence and metastasis of breast cancer were analyzed. @*Results@#There were differences in the expression levels of tumor markers for different molecular subtypes of breast cancer. The expression levels of CA15-3 in patients with Her-2 overexpression were significantly higher than that with Luminal A, Luminal B or Basal-like (χ 2 =7.98,P=0. 04). The differentiation degree of tumor cells in different molecular subtypes of breast cancer was different, and the proportion of low differentiation in the patients with Her-2 overexpression was significantly higher than that with Luminal A, Luminal B or Basal-like (χ 2 =12.42,P=0.006). There was also differences in the recurrence and metastasis of tumor for 4 subtypes of breast cancer, and the highest recurrence and metastasis rate existed in the patients with Her-2 overexpression (F=8.69,P=0.034). The multivariate Cox regression analysis showed that tumor diameter, degree of tissue differentiation and presence or absence of vascular tumor thrombus were independent risk factors for the recurrence and metastasis of breast cancer patients (all P＜0.05). @*Conclusion@#The breast cancer patients with Her-2 overexpression have high levels of CA15-3 and poor prognosis, which suggests that the individualized treatment of breast cancer should be combined with molecular subtyping, tumor markers and related risk factors.
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Objective To investigate the expression of microrchidia 2(MORC2) in glioblastoma patients and to evaluate its prognostic value of MORC2 expression combined with IDH1 mutation status for chemoradiotherapy efficacy and new molecular subtype.Methods The expression level of MORC2 in 45 glioblastoma tissues was measured by immunohistochemical staining and its correlation with clinicopathological characteristics and clinical prognosis after chemoradiotherapy was analyzed.Further more,the prognostic values of the expression of MORC2 combined with the status of IDH1 were assessed in a glioblastoma CGGA mRNA dataset.Results High expression of MORC2 was observed in 76％ of glioblastoma patients,which was negatively correlated with overall survival (HR=2.928,95％CI:1.582-5.418,P=0.002;recurrence-free survival (HR=2.204,95％CI:1.186-4.095,P=0.022).Moreover,according to the prognosis value of MORC2 expression and IDH1 mutation status,glioblastoma patients were divided into 3 molecular subtypes.Patients with the subtype of IDH1mt/MORC2low obtained the best clinical prognosis with a median survival of 22 months (95％CI:13.98-30.02),whereas those with the subtype of IDH1wt/MORC2high obtained the worst clinical prognosis with a median survival of 5.63 months (95％CI:3.92-7.34,HR=4.15,95％CI:3.92-7.34,P=0.002).Among IDH1wt glioblastoma patients,MORC2high patients had worse clinical prognosis compared with MORC2low counterparts,prompting that IDH1wt/ MORC2high glioblastoma tissues yielded higher capability of DNA injury repairing and resistance to chemoradiotherapy.Conclusions The high expression of MORC2 can be used as a potential indicator of poor prognosis of glioblastoma patients after chemoradiotherapy.IDH 1 mutation status combined with MORC2 expression can establish a novel molecular subtyping,which provide evidence for stratified therapy for glioblastoma patients.
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Objective: To establish a prediction model for the distant metastasis of breast cancer based on qualitative magnetic reso-nance imaging (MRI) parameters. Methods: A retrospective analysis of 3,032 patients with breast MRI from January 2011 to Decem-ber 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. After the confirmation of invasive breast cancer, the subjects were divided in 2 groups: metastasis and metastasis-free. A total of 93 patients were included in the metastasis group, and 186 patients without the presence of distant metastasis in the metastasis-free group. We analyzed the correlation between breast cancer molecular subtypes and distant metastasis in the metastasis group. Univariate and Logistic regression analyses of qualitative MRI features were performed for the groups. Subsequently, we used the results to establish prediction models. Results: The results showed that hormone receptor-positive tumors (Luminal type) had a greater tendency to develop bone metastasis in the metastasis group. Triple-negative tumors showed a greater tendency to develop lung metastasis. Human epidermal growth factor receptor 2 gene overexpression cases were more likely to develop liver metastasis. The results of the univariate analysis showed that the type of le-sion, multifocality or multicentricity of the cancer, T1-weighted signal uniformity, T2-weighted signal uniformity, and tumor size were statistically different between the groups (P<0.05). The results of the logistic regression analysis showed that the type of lesion, multi-focality or multicentricity of the cancer, T2-weighted signal uniformity, and tumor size were independent predictors of distant metasta-sis. Based on select independent predictors, we established a prediction model for the distant visceral metastasis of breast cancer. The accuracy, area under the curve, sensitivity, and specificity of the model were 82.8%, 0.801, 85.7%, and 75.0%, respectively. Conclu-sions: The prediction model based on the clinical pathology and MRI features established in this study can predict the distant metasta-sis of breast cancer.
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Objective To explore the ultrasonographic features of different molecular subtypes of no specific type invasive breast carcinoma. Methods According to immunohistochemical results, 193 patients with no specific type invasive breast carcinoma were divided into 4 molecular subtypes, i.e. Luminal A-like type (n=46), Luminal B-like type (n=98), HER-2 expression type (n=22) and basal-like type (n=27). The ultrasonographic features of the 4 molecular subtypes breast carcinoma were retrospectively analyzed, including the shape, edge, direction, internal echo, rear echo change, calcification, blood flow, tumor sizes, histopathological grade and lymph node metastasis. Results There was no statistically significant difference in the tumor sizes (0.05), but in the histopathological grade (grade , Ⅱ, III), there was a statistically significant difference (P<0.01). Totally 6 ultrasonographic features (shape, edge, direction, internal echo, rear echo change and calcification) had statistically significant differences among 4 subtypes (all P<0.01), while the blood flow had no statistically significant difference (P=0.16). Conclusion The ultrasonographic features of different molecular subtypes of no specific type invasive breast carcinoma have certain characteristics. The difference of ultrasonographic features is limited between Luminal A-like and Luminal B-like types, which may bring difficulties for differential diagnosis.
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Objective: To explore the correlation of quantitative features of shear wave elastography (SWE) of breast cancer with its molecular subtypes and histopathological features. Methods: The 107 lesions of 106 cases of breast cancer confirmed by pathology were examined by conventional ultrasonography and SWE before surgery. The maximum elasticity values (E Max) and elasticity ratio (E ratio) were recorded. We also recorded the immunohistochemical features including clinical pathological features and molecular subtypes (Luminal A, Luminal B, Erb-B2 overexpression and Basal-like), and analyzed its correlation with E Max and E ratio. Results: There were significant differences in mass size, pathological grade, BI-RADS classification, E Max and E ratio between the 4 subtypes (P<0.05). As for hardness among the 4 subtypes, the largest one was Erb-B2 overexpression, followed by Luminal-like and the smallest was Basal-like, with statistically significant differences among the subgroups (P<0.05). The stiffness of various pathological types of breast cancer was disparate, among which mucous carcinoma was the hardest, followed by ductal carcinoma and medullary carcinoma, and lobular carcinoma was the softest. The E Max and E ratio increased with the increase of mass size with linear correlation. The higher the pathological grade and BI-RADS classification of the lesion, the greater value of E Max and E ratio, with significant differences (P<0.05). Conclusion: There is a certain degree of correlation between the stiffness of breast cancer and its molecular subtypes and histopathological features. The evaluation of lesions by SWE can provide important reference for endocrine therapy and prognosis evaluation of breast cancer.
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@# Objective: To discuss the relationship between lymph node metastasis rate and the prognosis of patients with stage II and III breast cancer with different molecular subtypes. Methods: The clinical data of 311 patients diagnosed with stage II and III breast cancer, who received preferred surgical treatment in Changzhou Second People's Hospital Affiliated to Nanjing Medical University from January 2011 to January 2016, were retrospectively analyzed. According to the levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2) and Ki-67 proliferation index, the patients were divided into four groups, namely, Luminal A, Luminal B, HER2 over-expression and triple negative breast cancer (TNBC). Chi-square test was used to analyze the clinical characteristics of patients in different groups. Kaplan-Meier survival curve was used to evaluate the prognostic impact of axillary lymph node metastasis rate (LNR) on patients with different types of breast cancer, and the prognostic differences among breast cancer patients with different molecular subtypes under the same LNR. Spearman correlation was used to analyze the correlation between LNR and Ki-67 proliferation index. Results: There were no significant differences in clinical characteristics of age, menopause, tumor size, lymph node status and metastasis site among BC patients with different molecular subtypes (all P>0.05). There was no significant difference in disease-free survival (DFS) among the four subgroups with LNR of 0 or >0.65 (χ2=3.581, 2.808, all P>0.05); and there was significant difference in DFS among the four subgroups with LNR between 0.01 and 0.65 (χ2=24.366, 8.169, all P<0.05). LNR was positively correlated with the Ki-67 proliferation index (r=0.125, P<0.05). Multivariate Cox regression analysis showed that the prognosis of breast cancer patients was related to molecular subtypes (RR=1.179, 95%CI=1.023-1.358; χ2=5.165, P<0.05), LNR (RR =1.137, 95%CI=0.985-0.999; χ2=5.589, P<0.05) and Ki-67 proliferation index (RR=0.992, 95%CI=1.022-1.264; χ2=5.623， P<0.05). Conclusion: LNR is an important prognostic factor for stage II and III breast cancer. With the same LNR, the prognosis of breast cancer patients with different molecular subtypes varies greatly. LNR is positively correlated with Ki-67 proliferation index.